• Title/Summary/Keyword: Health risks

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Quantity over Quality? Perception of Designating Long-Term Care Hospitals as Providers of Hospice and Palliative Care

  • Kim-Knauss, Yaeji;Jeong, Eunseok;Sim, Jin-ah;Lee, Jihye;Choo, Jiyeon;Yun, Young Ho
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.145-155
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    • 2019
  • Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

A Study on Agrifood Purchase Decision-making and Online Channel Selection according to Consumer Characteristics, Perceived Risks, and Eating Lifestyles (소비자 특성, 지각된 위험, 식생활 라이프스타일에 따른 농식품 구매결정 및 온라인 구매채널 선택에 관한 연구)

  • Lee, Myoung-Kwan;Park, Sang-Hyeok;Kim, Yeon-Jong
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.1
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    • pp.147-159
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    • 2021
  • After the 2020 Corona 19 pandemic, consumers' online consumption is increasing rapidly, and non-store online retail channels are showing high growth. In particular, social media is gaining its status as a social media market where direct transactions take place in the means of promoting companies' brands and products. In this study, changes in consumer behavior after the Corona 19 pandemic are different in choosing online shopping media such as existing online shopping malls and SNS markets that can be classified into open social media and closed social media when purchasing agri-food online. We tried to find out what type of product is preferred in the selection of agri-food products. For this study, demographic characteristics of consumers, perceived risk of consumers, and dietary lifestyle were set as independent variables to investigate the effect on online shopping media type and product selection. The summary of the empirical analysis results is as follows. When consumers purchase agri-food online, there are significant differences in demographic characteristics, consumer perception risks, and detailed factors of dietary lifestyle in selecting shopping channels such as online shopping malls, open social media, and closed social media. Appeared to be. The consumers who choose the open SNS market are higher in men than in women, with lower household income, and higher in consumers seeking health and taste. Consumers who choose the closed SNS market were analyzed as consumers who live in rural areas and have a high degree of risk perception for delivery. Consumers who choose existing online shopping malls have high educational background, high personal income, and high consumers seeking taste and economy. Through this study, we tried to provide practical assistance by providing a basis for judgment to farmers who have difficulty in selecting an online shopping medium suitable for their product characteristics. As a shopping channel for agri-food, social media is not a simple promotional channel, but a direct transaction. It can be differentiated from existing studies in that it is approached as a market that arises.

Effects of Culture Media and Oxygen Concentration on In Vitro Development of Porcine IVM/IVE Embryos (배양액 및 산소농도가 돼지 체외수정란의 발달에 미치는 영향)

  • Choe, C.Y.;Choe, S.R.;Choi, S.H.;Kim, H.J.;Han, M.H.;Kang, D.W.;Shin, Y.W.;Han, J.H.;Son, D.S.
    • Journal of Embryo Transfer
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    • v.22 no.3
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    • pp.155-160
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    • 2007
  • During in vitro culture of mammalian oocytes and embryos, the cells are exposed to the risks that cause cell injury or death. Numerous studies have been reported that the cell injury may be induced by the action of free radicals generated by auto-oxidation. This study was undertaken to investigate the optimal culture condition system for in vitro culture of porcine embryos. We first evaluated the effect of culture media on the porcine embryo development. NCSU-23 and PZM-5, culture medium tested, were failed to produce significant difference on the rate of blastocyst formation. In NCSU-23, the developmental rate was slightly higher than that in PZM-5. During in vitro maturation (IVM), fertilizaton (IVF), and culture (IVC) under 5 or 20% oxygen ($O_2$), the rates of cleavage and development were insignificantly different from each other under our culture condition (20% $O_2$, in NCSU-23), the mean cell number per blastocyst was $40{\pm}10$. These results showed that medium and $O_2$ concentration had no significant effect on the development of porcine embryos.

Quantitative Microbial Risk Assessment Model for Staphylococcus aureus in Kimbab (김밥에서의 Staphylococcus aureus에 대한 정량적 미생물위해평가 모델 개발)

  • Bahk, Gyung-Jin;Oh, Deog-Hwan;Ha, Sang-Do;Park, Ki-Hwan;Joung, Myung-Sub;Chun, Suk-Jo;Park, Jong-Seok;Woo, Gun-Jo;Hong, Chong-Hae
    • Korean Journal of Food Science and Technology
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    • v.37 no.3
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    • pp.484-491
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    • 2005
  • Quantitative microbial risk assessment (QMRA) analyzes potential hazard of microorganisms on public health and offers structured approach to assess risks associated with microorganisms in foods. This paper addresses specific risk management questions associated with Staphylococcus aureus in kimbab and improvement and dissemination of QMRA methodology, QMRA model was developed by constructing four nodes from retail to table pathway. Predictive microbial growth model and survey data were combined with probabilistic modeling to simulate levels of S. aureus in kimbab at time of consumption, Due to lack of dose-response models, final level of S. aureus in kimbeb was used as proxy for potential hazard level, based on which possibility of contamination over this level and consumption level of S. aureus through kimbab were estimated as 30.7% and 3.67 log cfu/g, respectively. Regression sensitivity results showed time-temperature during storage at selling was the most significant factor. These results suggested temperature control under $10^{\circ}C$ was critical control point for kimbab production to prevent growth of S. aureus and showed QMRA was useful for evaluation of factors influencing potential risk and could be applied directly to risk management.

Study on the Methodology of the Microbial Risk Assessment in Food (식품중 미생물 위해성평가 방법론 연구)

  • 이효민;최시내;윤은경;한지연;김창민;김길생
    • Journal of Food Hygiene and Safety
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    • v.14 no.4
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    • pp.319-326
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    • 1999
  • Recently, it is continuously rising to concern about the health risk being induced by microorganisms in food such as Escherichia coli O157:H7 and Listeria monocytogenes. Various organizations and regulatory agencies including U.S.FPA, U.S.DA and FAO/WHO are preparing the methodology building to apply microbial quantitative risk assessment to risk-based food safety program. Microbial risks are primarily the result of single exposure and its health impacts are immediate and serious. Therefore, the methodology of risk assessment differs from that of chemical risk assessment. Microbial quantitative risk assessment consists of tow steps; hazard identification, exposure assessment, dose-response assessment and risk characterization. Hazard identification is accomplished by observing and defining the types of adverse health effects in humans associated with exposure to foodborne agents. Epidemiological evidence which links the various disease with the particular exposure route is an important component of this identification. Exposure assessment includes the quantification of microbial exposure regarding the dynamics of microbial growth in food processing, transport, packaging and specific time-temperature conditions at various points from animal production to consumption. Dose-response assessment is the process characterizing dose-response correlation between microbial exposure and disease incidence. Unlike chemical carcinogens, the dose-response assessment for microbial pathogens has not focused on animal models for extrapolation to humans. Risk characterization links the exposure assessment and dose-response assessment and involve uncertainty analysis. The methodology of microbial dose-response assessment is classified as nonthreshold and thresh-old approach. The nonthreshold model have assumption that one organism is capable of producing an infection if it arrives at an appropriate site and organism have independence. Recently, the Exponential, Beta-poission, Gompertz, and Gamma-weibull models are using as nonthreshold model. The Log-normal and Log-logistic models are using as threshold model. The threshold has the assumption that a toxicant is produce by interaction of organisms. In this study, it was reviewed detailed process including risk value using model parameter and microbial exposure dose. Also this study suggested model application methodology in field of exposure assessment using assumed food microbial data(NaCl, water activity, temperature, pH, etc.) and the commercially used Food MicroModel. We recognized that human volunteer data to the healthy man are preferred rather than epidemiological data fur obtaining exact dose-response data. But, the foreign agencies are studying the characterization of correlation between human and animal. For the comparison of differences to the population sensitivity: it must be executed domestic study such as the establishment of dose-response data to the Korean volunteer by each microbial and microbial exposure assessment in food.

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The studies about the weight-changes during pregnancy and the condition of mother and infant (임신 중 체중변화와 임부 및 신생아 상태에 관한 연구)

  • Park, Kwang-Hee
    • Korean Parent-Child Health Journal
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    • v.4 no.1
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    • pp.68-81
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    • 2001
  • This research is to study about the weight-change of a pregnant woman, conditions of the woman and an infant. The weight-change of a mother during pregnancy was observed and that was expressed as the basis on the body mass index of a mother before pregnancy. The effects of weight-changes on both the discomfort, complications of pregnant mother and the condition of an infant were also investigated. Thus we set a purpose that this study would help pregnant woman and an infant to maintain and enhance their health conditions by proper weight control through nursing mediation. This study was performed in a certain hospital of university in seoul from Feb. 1. 2000 to Mar. 31. 2000. We explained the purpose of this study to the hospital institution and obtained consent of investigation. 152 inpatients who were in condition from PA 37 weeks to PA 42 weeks were the subject of this study. The research materials were made through of question paper that inpatients make answer by themselves and investigation paper. The question paper was about general background, weight and height before pregnancy and discomfort of the physical degree. And the investigation paper was about parity, maternal weight(late pregnancy), high pregnancy, delivery method, hemoglobin level, Apgar score, fetal weight. Physical discomfort was measured using the implement made by Kim hae won(1996) (chronbach's ${\alpha}=0.85$). SPSS was used to do statistics for managing and analyzing data. The results of this study were like followings. 1. The mean value of gained weight during pregnancy was about 13.8kg within from 3 kg to 26 kg. Among 152 research candidates, the gained weight of 80(52.6%) candidates remained within an ideal range. But that of 37 candidates(24.3%) became less than the ideal range. Also that of 35 candidates(23.0%) became over than the ideal range. 2. In the investigation of the relation between the weight change of a pregnant woman and her condition, the scores to represent physical discomfort were middle in all candidates. And the physical discomfort of over weight-gained group was more than that of low weight-gained group, but there was no difference in statistics(F=0.234, p=0.791). The weight-changes of pregnant woman didn't have an influence with the high risk of pregnancy(F=0.509, p=0.477). Also, the weight-changes didn't have an influence on delivery method($x^2=3.825$, p=0.148). However, in the investigation of the relation between weight-change and hemoglobin level, the change of hemoglobin level was highest in over weight gained group(F=3.062, p=0.05). 3. In the investigation of the weight-change of pregnant woman and the condition of infant. the weight changes didn't have an influence on both 1 min Apgar score(F=0.157, p=0.855) and 5 min Apgar score(F=0.030, p=0.970) of infant. Also, in the investigation of weight-change of a pregnant woman and weight difference of a infant with Pearson Correlation Coefficient, the weight-change of a pregnant woman affected vastly the weight of a infant. It was also found that the more pregnant woman gained in weight, the more did gain weighty infants. This relation was in net proportion(r=0.256, p=0.001). In conclusion, these results suggest that the weight-changes during pregnancy in Korea women of these days are more increased than that of the past days and individual variation in weight-changes is very high. Also, these results suggest that the changed hemoglobin level of a mother and weight of an infant were meaningfully affected by the weight-changes of a pregnant woman during pregnancy. However, the physical discomfort of a pregnant woman, the high risks of pregnancy, the delivery method and Apgar score of an infant were not affected by the weight-changes during pregnancy. Because the recommendation suggesting the ideal weight-change, used this study, is basis on the subject of American women, therefore, these results also suggest the necessity of such recommendation which is subject to Korean women.

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Effects of Regular Walking Exercise on Health-Related Parameters in Persons with Chronic Diseases (규칙적인 걷기운동이 질환별 노인의 건강변인에 미치는 효과)

  • Lim, Hwe-Jin;Kim, Yu-Sik;Cho, Hyeong-Suk;Kim, Chang-Hee;Lim, Hee-Jung;Jeong, Hee-Seong;Im, Jee-Aee;Yoon, Byung-Kon;Paik, Il-Young;Suh, Sang-Hoon
    • Journal of Life Science
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    • v.19 no.12
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    • pp.1750-1757
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    • 2009
  • The purpose of this study was to investigate the effects of regular walking exercise on health-related parameters in the elderly with chronic diseases - apoplexy, overweight, impaired fasting glucose, and overweight + impaired fasting glucose. A total of 85 subjects, 27, 17, 21 and 20 in apoplexy (A), overweight (O), impaired fasting glucose (IFG), overweight + impaired fasting glucose group (O_IFG), respectively, completed a 12-week walking exercise. The health-related parameters were measured before and at the completion of the exercise program including anthropometric measurements, functional physical fitness levels, blood pressure, fasting glucose, blood lipid profiles and chronic inflammatory markers (CRPs). Significant improvements in body weight, BMI, %body fat, blood pressure, all blood lipid measurements and all measured physical fitness items were shown in A; those in %body fat, TC, HDL-C and LDL-C in O; those in body weight, BMI, %body fat, fasting glucose, TC, TG and HDL-C in IFG; and those in body weight, HDL-C and LDL-C in O_IFG (p<0.05). The results of the present study demonstrated that a 12-week walking exercise brought positive effects on body weight, bloody lipid profiles, fasting glucose and functional physical fitness levels in the elderly with chronic diseases. In conclusion, this study suggested that walking regularly is very effective in lowering the risks of developing chronic diseases.

Cost-Benefit Analysis on Rubella Vaccination Policy (풍진 예방접종사업의 비용-편익분석)

  • Shin, Young-Jeon;Choi, Bo-Youl;Park, Hung-Bae;Moon, Ok-Ryun;Yoon, Bae-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.337-365
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    • 1994
  • Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.

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Research on Factors Influencing the Change of the Types of the Occupation and the Income by Medical Expenditure (의료비 지출이 종사상 지위 및 소득변화에 미치는 요인연구)

  • Ji, Eun-Jeong
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.5-35
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    • 2004
  • This research is about the change of the occupation and the income of the subscriber of the medical expenditure due to the economic influence on them. The data of this study are based on 4,215 of medical cost payers among respondents of the survey on "Health and Retirement", which was the fourth additional research of Korea Labor and Income Panel Survey. The main findings of this study are as follows: First, the average medical cost is 5.5% of the income. The ratio of the medical cost to an earned income is highly different between low-income group and high income group. For the low income group, the medical cost reaches up to 1/3 of the total family income. That proves that the medical cost si a heavy burden on them. The group with the high medical expenditure seems to be supported by their own private property and other family members whenever it is needed. But it doesn't show the exact sources of the property, which includes the fund from the interests and real estates. On the other hand, only 14.4% of the subscribers changed their job status on the 5th year, and 85.6% of those kept their job status until the 5th year from the 4th year. This shows that the amount of the medical cost could be the important factor for them to change their job; for example, it is crucial whether the medical expenditure is over the average rate or not. Furthermore, the change of the occupation caused by the medical cost has the negative influence on the gross income. It makes the economic conditions of the family get worse. Therefore, the health insurance in Korea is lack of the compensational function, which substitutes the family income reduced by the change of the job status due to the high medical cost.

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The effect of high-carbohydrate diet and low-fat diet for the risk factors of metabolic syndrome in Korean adolescents: Using the Korean National Health and Nutrition Examination Surveys (KNHANES) 1998-2009 (우리나라 청소년의 고탄수화물 식사와 고지방 식사가 대사증후군 위험요인에 미치는 영향: 1998~2009년 국민건강영양조사 자료를 이용하여)

  • Han, Mi-Rhan;Lim, Jeong Hyun;Song, YoonJu
    • Journal of Nutrition and Health
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    • v.47 no.3
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    • pp.186-192
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    • 2014
  • Purpose: The prevalence of metabolic syndrome has increased in both the adult population and in adolescents. However, few studies have been conducted for adolescents. The aim of this study was to examine the association of metabolic syndrome and its risk factors with high carbohydrate diet and high fat diet using data from the Korea National Health and Nutrition Examination Survey (1998-2009). Methods: Using the Acceptable Macronutrient Distribution Range for Korean Dietary Reference Intakes, subjects whose energy intake from carbohydrate was greater than 70% and from fat was less than 15% were classified as the 'High-carbohydrate & low-fat diet (HCLF)' group and subjects whose energy intake from carbohydrate was less than 60% and from fat was 25% or more were classified as the 'Low-carbohydrate & high-fat Diet (LCHF)' group. Among 5,931 eligible subjects, HCLF included 853 subjects and LCHF included 1,084 subjects. Results: The mean age in both groups was 14 years and significant difference in age, BMI, sex, physical activity, and household income was observed between the HCLF and LCHF groups. Regarding the energy intake compared to Estimated Energy Requirement, the HCLF group met 79.0% and the LCHF group met 100.3%. Regarding nutrient intake per 1,000 kcal, carbohydrate, iron, potassium, and vitamin C intake in the HCLF group were significantly higher, but protein, fat, calcium, phosphorus, vitamin A, thiamin, riboflavin, and niacin intakes were significantly lower in the HCLF group compared to the LCHF group. After adjusting for age, sex, BMI, study year, household income, physical activity, and energy intake, the serum triglycerides level and systolic blood pressure were slightly higher, while the serum HDL-cholesterol level was significantly lower in HCLF than LCHF. The odds ratio of metabolic syndrome did not differ significantly between HCLF and LCHF. Conclusion: Our findings indicate an association of a high carbohydrate diet with increased risks for metabolic syndrome components. Conduct of future studies would be necessary in order to explore the underlying mechanism and to confirm our findings in a prospective study.